DANIELLE BLAIR Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****38

License Status

INOPERATIVE

Business

First Name

DANIELLE

Last Name

BLAIR

Business Name

DANIELLE BLAIR

Original Issue Date

08/15/2011

Effective Date

02/08/2016

Expiration Date

03/01/2018

City

HINSDALE

State

Zip

60521

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/02/2018